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1 GUIDELINES TO PREVENT TRANSMISSION OF INFECTIOUS DISEASES IN SCHOOLS May 1991 Precautions, Procedures and Instructions for Handling Body Fluids DUVAL COUNTY PUBLIC SCHOOLS

2 CONTENTS PAGE Introduction General Precautions for All School Personnel When Handling Body Fluids and Potentially Contaminated Materials...97 Special Precautions for Health Care Workers/School Nurses In Exceptional Child Centers When Handling Body Fluids.98 General and Special Cleaning Procedures for School Custodians.99 Instructions for Cleaning Any Potentially Contaminated Blood Spills Using the ChloraSorb Clean-Up Kit.100 Appendix - Contents of ChloraSorb Clean-Up Kit

3 DUVAL COUNTY PUBLIC SCHOOLS GUIDELINES TO PREVENT TRANSMISSION OF INFECTIOUS DISEASES IN SCHOOLS Introduction In an effort to prevent transmission (spread) of infectious diseases in the schools and to ensure that body fluids involving blood, vomitus, urine, feces, saliva, and nasal discharges are handled properly, the following guidelines have been developed for school personnel. Recently, much concern has been expressed about the transmission of diseases such as Hepatitis B and AIDS in schools. However, since we are not certain of all the methods of transmission of the human immunodeficiency virus (HIV), the virus that causes AIDS, precautions should be taken in handling all body fluids containing blood or blood products. This is especially true when the person handling body fluids has an open lesion of the skin. General Precautions for All School Personnel When Handling Body Fluids and Potentially Contaminated Materials A. General Precautions: All school personnel should use precautions when handling body fluids involving nasal discharges, nose bleeds, draining boils, draining ears, impetigo, etc., and when handling contaminated items such as used bandages and dressings. It is important to be reminded that some persons with no apparent symptoms may be unrecognized carriers and may be infectious. DISPOSABLE GLOVES SHOULD BE IMMEDIATELY AVAILABLE AT ALL TIMES IN THE DESK OR WORKING AREA OF ALL SCHOOL PERSONNEL. Disposable gloves may be obtained from the School Board Storeroom. 1. Disposable gloves should be worn when making contact with body fluids especially, if you have an open sore or cut on hands. 2. Gloves should be discarded after each use. 3. Disposable items such as disposable gloves, paper towels and tissues should be used to handle body fluids. 4. Hands should be washed thoroughly with soap and running water after handling body fluids and contaminated articles, whether or not gloves are worn. 5. Disposable items such as used bandages, dressings, and sanitary napkins should be discarded in plastic-lined trash containers with lids. Receptacles lined with a bag for discarded sanitary napkins should be available in every restroom for girls. Trash bags should be closed, tied and discarded daily.

4 6. Plastic bags should not be reused. 7. The custodian should be contacted when assistance is needed in cleaning up spills of blood and body fluids. (See page 101 of these guidelines for General and Special Procedures for School Custodians.) B. ChloraSorb Clean-Up Kit: All Duval County Public Schools will be supplied with a ChloraSorb Clean-Up Kit to be used by custodians to clean up and sanitize any accidental spill of blood or blood products (see page 102). Special Precautions for Health Care Workers/School Nurses in Exceptional Child Centers When Handling Body Fluids and Containers A. All health care workers should routinely use appropriate barrier precautions to prevent skin and mucous-membrane exposure when contact with blood or other body fluids of any patient is anticipated. Gloves should be worn when touching blood and body fluids, mucous membranes, or non-intact skin of all patients and when handling items or surfaces soiled with blood or body fluids. Gloves should be changed after contact with each patient. Gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids. B. Hands and other skin surfaces should be washed immediately and thoroughly if contaminated with blood or other body fluids. Hands should be washed immediately after gloves are removed. C. All health care workers should take precautions to prevent injuries caused by needles. When cleaning used instruments and during disposal of used needles, precautions should likewise be taken. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand, removed from disposable syringes or otherwise manipulated by hand. After they are used, disposable syringes and needles should be placed in the Isolyser SMS container for disposal; this container should be located as close as practical to the use area. The Isolyser container shall be disposed of according to directions after it is full. D. Although pure saliva has not been implicated in human immunodeficiency virus (HIV) transmission, when emergency resuscitation is needed, mouthpieces, resuscitation bags or other ventilation devices should be available for use in areas in which the need for resuscitation is predictable. E. Health care workers who have oozing lesions or weeping dermatitis should

5 refrain from all direct patient care and from handling patient-care equipment until the condition resolves. F. Pregnant health care workers are not known to be at greater risk of contracting HIV infection than health care workers who are not pregnant; however, if a health care worker develops HIV infection during pregnancy, the infant is at risk of infection resulting from perinatal transmission. Because of this risk, pregnant health care workers should be especially familiar with and strictly adhere to precautions to minimize the risk of HIV transmission.

6 General and Special Cleaning Procedures for School Custodians A. General Cleaning: Most areas of a school can be effectively cleaned using a properly mixed solution of a general purpose detergent for hard surfaces and a properly mixed solution of a carpet shampoo for carpeted surfaces. However, because of the increased possibility of disease-causing agents being present, certain areas of the school should be cleaned with a germicidal detergent solution. Such a product is available in the General Storeroom for school use. Areas to be cleaned with a germicidal detergent are restrooms, locker-shower rooms, clinic rooms, kitchen-cafeterias and water fountains. Cleaning procedures are as follows: 1. Gloves should be worn when cleaning these areas, not only to protect the custodian from possible disease agents but also possible skin reactions to the germicidal detergent; gloves are available through the General Storeroom. 2. When mixing cleaning products, the use of protective goggles is advisable; goggles are available through the General Storeroom. 3. Cleaning procedures to be followed are covered in the Duval County Public Schools Custodial Handbook; one or more copies of this handbook should be available in each school. 4. When cleaning is completed, the outside of the custodian s gloves should be washed in a properly mixed solution of germicidal detergent solution and then rinsed off with clean water; the custodian should then wash his or her hands thoroughly with soap and water; tools used in cleaning, such as mops, sponges, dust pans, etc., should also be thoroughly cleaned after each use. B. Special Cleaning: Custodians are frequently called upon to clean up body fluids such as blood, vomitus, urine, feces, saliva, and nasal discharges. Special precautions should be taken when cleaning up any of these fluids, especially blood or blood products. It is recommended that the procedures below be followed: 1. When cleaning up blood, custodians should use the ChloraSorb Clean- Up Kit; special instructions enclosed with the kit and outlined on page 101 of these guidelines should be followed. 2. When cleaning up vomitus, urine, etc., custodians should use the following procedures instead of the clean-up kit: a. Wear gloves

7 b. Sprinkle comet or other powdered cleanser on the spill until it is absorbed c. Use a broom and a dust pan to sweep up the congealed liquid d. Dispose of sweepings in a plastic bag e. Clean up any remaining soil with a germicidal detergent using a sponge and/or paper towels; do not get the sponge or towels too wet; dispose of the sponge and paper towels in a plastic bag and tie the bag closed; dispose of the bag in a dumpster. f. Finish the clean up of any remaining soil on hard surfaces such as a table or floor with a sponge or mop that has been dipped in a germicidal detergent solution and partially wrung out; allow the surface to air dry. g. If surface is a rug or upholstery, skip step (f) above and shampoo; let it dry and then vacuum to finish the clean up of any remaining soil. h. Rinse the outside of gloves and any tools used, such as a dustpan, broom, sponge or mop, in a germicidal solution and let them air dry. i. Wash hands thoroughly with soap and running water. Instructions For Cleaning Up Any Potentially Contaminated Blood Spills Using The ChloraSorb Clean-Up Kit All Duval County Public Schools will be supplied with a ChloraSorb Clean-Up Kit manufactured by Huntington Laboratories, to be used to clean up and sanitize any accidental spills of blood or blood products. Instructions in its use will be given to custodians and other appropriate personnel. The following special instructions in the use of this kit are enclosed. 1. Put on disposable gloves. 2. Sprinkle ChloraSorb on spill. Let it set until all fluid is absorbed. 3. Using the pick-up spatula, scoop the congealed liquid into a red plastic bag. 4. Using the hand broom and dust pan, sweep up all traces of the ChloraSorb and soil. Try not to create dust.

8 5. Place sweeping into the red plastic bag. If soil is from a person suspected of having AIDS, Hepatitis, or any other infectious disease, the spatula, broom and dust pan must be discarded into the red plastic bag. 6. Spray Tor Aerosol on the contaminated area. Let set for 10 minutes, then wipe with absorbent towel. Place soiled towel into red plastic bag. 7. Secure the opening of the red plastic bag with the tie. 8. Remove the disposable gloves and place the gloves and the sealed red plastic bag into a second red bag. Secure with a tie. 9. Wash hands with Cida-Rinse antiseptic alcohol rinse. Allow to air dry. 10. Spray Compass Aerosol on area to eliminate any lingering odor and as a final step in disinfection. Allow surface to air dry. 11. Dispose of plastic bags in accordance with local regulations. 12. After all handling and cleaning has been completed, rinse hands with Cida-Rinse. Allow hands to air dry.

9 Contents of this kit are: CLEAN-UP KIT with ChloraSorb ChloraSorb, Stabilized Chlorine Absorbent Deodorant Disposable Gloves Absorbent Towels Pick-Up Spatula Hand Broom Dust Pan Plastic Bags With Ties Tor Aerosol Germicidal Cleaner Compass Aerosol Deodorizer Cida-Rinse Alcohol Hand Rinse The fastest, most efficient method for the absorption and disposal of potentially harmful blood and body fluids. Don t take chances. In today s environment, it just doesn t make sense to take chances with your own well being. With this simple-to-use clean-up kit, you don t have to. You never have to come in direct contact with any spill. The stabilized chlorine absorbent, ChloraSorb, works quickly to confine the spill, and the disposable component of this kit will help prevent cross contamination. Protect yourself. You are safest if you assume all body fluids are contaminated and therefore potentially harmful to your health. National health authorities have consistently recommended the application of a chlorine compound to spilled contaminated body fluids such as blood, vomit, urine and feces. The ChloraSorb absorbent deodorant in the kit contains 10,000 ppm of stabilized chlorine. Product Number HL Huntington Huntington Laboratories, Inc., Huntington, Indiana ; In Canada, call collect ; Lansdale, PA 19446; Dallas, TX 75227; Denver, CO 80205; Oakland, CA 94621; Bramalea, Ontario, Canada L6T1E3 HL-11275

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